Provider Demographics
NPI:1699819607
Name:ROTH, KAREN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:ROTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-5316
Mailing Address - Country:US
Mailing Address - Phone:914-245-3028
Mailing Address - Fax:
Practice Address - Street 1:2269 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3832
Practice Address - Country:US
Practice Address - Phone:914-345-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP062339-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical